Congenital/prelingual hearing loss (HL) is one of the most common birth defects in the U.S. Infant HL occurs without respect to ethnic background, gender, or socioeconomic status. The aim of early hearing detection and intervention (EHDI) programs is to identify infants with hearing loss (HL) as early as possible so that the intervention process can take place in a timely manner. Timely early intervention for infants with hearing loss maximizes the potential for successful speech, language, literacy, and academic outcomes. Research suggests that many parents are not well prepared to make the necessary decisions in a timely manner. Family training and practice in the decision-making strategies can facilitate the intervention process and reduce intervention delays. Current EHDI programs do not address these issues. A family-focused outcomes-based decision-making model which links the timing of decision-making events to desired amplification, speech, language, and academic goals is proposed. Effective decision-making skills, timeliness of parental/family decisions, and an increase in self-efficacy can facilitate the intervention process and reduce intervention delays. A new digital technology, eDVD technology, is a promising solution for collaborative shared decision-making experiences. eDVD combines the persuasiveness of a shared video experience with the interactivity of computers. Parents and other family members can interact with the eDVD video in the comfort of their living room. The goal of this project is to develop and evaluate an eDVD technology tool called Making EHDI Decisions: An eDVD Tool for Families. We hypothesize that eDVD- based tools can be developed that facilitate viewer interaction, communication, and participation in cooperative learning and planning activities, and that such cooperative decision-making among parents and family members will result in better treatment outcomes and management of infant HL. During Phase I, the feasibility of this approach will be evaluated using a pre- and post-treatment design. In Phase 1 two modules will be systematically developed, these are: (a) family decision making strategies, and (b) amplification/implant options. The modules will undergo thorough usability testing. Pre- and post-intervention measures will include a self-efficacy scale and family coping style inventory. In Phase II we will complete the EHDI Decisions program by developing three collaborative learning eDVDs designed for three DM stages of the EHDI process: (a) amplification /implant, (b) speech-language intervention services, and (c) educational options. We will also conduct a national randomized clinical trial to evaluate the effectiveness of the completed program with parents and family members of infants with HL. EHDI Decisions will be designed for use as part of existing state EHDI programs and other early intervention programs. This application of cooperative learning technologies via eDVD will have broad applications to other health education and health promotion activities. [unreadable] [unreadable] [unreadable]